Haynes R B, Walker C J
Arch Intern Med. 1987 Jul;147(7):1297-301.
Computerized information systems hold the promise of overcoming problems in the management of clinical information Many of the claims of the creators and promoters of these systems, however, are not based on sound clinical studies. To determine the ability of computer information systems to improve the quality of medical care, we applied methodologic criteria to published articles in the field. Only 30 (22%) of 135 articles reported preplanned investigations, and only half of these met minimal criteria for scientific investigations. Fourteen studies were well designed and executed. All studies reported improvements in the process of care. However, patient outcomes were not measured, not affected, or only minimally influenced. While computer information systems show increasing potential, more work is required to enhance their effect on the quality of care and thus on patient outcomes.
计算机化信息系统有望解决临床信息管理中的问题。然而，这些系统的创建者和推广者的许多说法并非基于可靠的临床研究。为了确定计算机信息系统改善医疗质量的能力，我们将方法学标准应用于该领域已发表的文章。135篇文章中只有30篇（22%）报告了预先计划的调查，其中只有一半符合科学调查的最低标准。14项研究设计良好且执行得当。所有研究都报告了护理过程的改善。然而，未对患者结局进行测量、未产生影响或仅有极小的影响。虽然计算机信息系统显示出越来越大的潜力，但仍需要开展更多工作来增强其对护理质量进而对患者结局的影响。
